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By the provision of documentation showing current participation in a public benefit program such as Medicaid; County Indigent Health Program; AFDC; Food Stamps; WIC; Medicare Low Income Subsidy; TexCare Partnership; or other similar means tested programs.","source_id":"billing-709cdb7b0020e45b","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":{"value":"BSWHealth.com/FinancialAssistance","layer":"documented","quote":"Online: BSWHealth.com/FinancialAssistance","source_id":"summary-d4d040a8d68c9cd1","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"form_version":null,"documents_required":{"value":["proof_of_income","social_security_letter","tax_return","bank_statements","insurance_card"],"layer":"documented","quote":"Household income will be documented through any of the following mechanisms: 5.3.i. Third Party Documentation. By the provision of third party financial documentation including IRS Form W-2; Wages and Tax Statement; pay check remittance; individual tax return; telephone verification by employer; bank statements; Social Security payment remittance; Worker's Compensation payment remittance; unemployment insurance payment notice; Unemployment Compensation Determination Letters; response from a credit inquiry and other publicly available information; or other appropriate indicators of the patient's income.","source_id":"billing-709cdb7b0020e45b","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":{"value":365,"layer":"documented","quote":"Patients may apply for financial assistance from the date a patient is scheduled for service or the service is rendered, whichever is earlier, through the 365th day after the first billing statement is provided (except as provided in Section 5.4.iii).","source_id":"billing-709cdb7b0020e45b","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"1.972.892.3026","layer":"documented","quote":"Over the phone: 1.972.892.3026","source_id":"summary-d4d040a8d68c9cd1","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["English","Spanish"],"layer":"documented","quote":"English, Spanish and certain other language versions of the FAP application are available upon request.","source_id":"summary-d4d040a8d68c9cd1","checked_on":"2026-10-10","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["BAYLOR SCOTT & WHITE MEDICAL CENTER PFLUGERVILLE"],"layer":"documented","quote":"Baylor Scott & White Medical Center - Pflugerville","source_id":"billing-709cdb7b0020e45b","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"summary-d4d040a8d68c9cd1","kind":"hospital_web","url":"https://www.bswhealth.com/-/media/Project/BSW/Sites/BSWHealth/Documents/patient-tools/patient-registration-and-billing/plain-language-summary-financial-assistance-policy-bswmc-sunnyvale.pdf","title":"[PDF] Plain Language Summary Financial Assistance Policy","fetched_on":"2026-10-10","sha256":"d4d040a8d68c9cd139fad171bcd98e5ccba28d50e7366d3e8935bd077c5f3f53","effective_date":null},{"id":"billing-709cdb7b0020e45b","kind":"hospital_web","url":"https://www.bswhealth.com/-/media/Project/BSW/Sites/BSWHealth/Documents/patient-tools/patient-registration-and-billing/financial-assistance-policy.pdf","title":"Baylor Scott & White Health Page 1 of 10 Title: Financial Assistance (Hospital Facilities)","fetched_on":"2026-10-10","sha256":"709cdb7b0020e45b2cacef95dd792df3c1a30cfe0907f2e4355cb4aae1acd20f","effective_date":null},{"id":"summary-ddd19ddf01979479","kind":"hospital_web","url":"https://www.bswhealth.com/-/media/Project/BSW/Sites/BSWHealth/Documents/patient-tools/patient-registration-and-billing/plain-language-summary-financial-assistance-policy-bsweh.pdf","title":"[PDF] Plain Language Summary Financial Assistance Policy","fetched_on":"2026-10-10","sha256":"ddd19ddf019794791d0ae7dfb1893d4d08e08997a06cdccd0055f791d8b518cd","effective_date":null},{"id":"summary-1133b24e1c82c695","kind":"hospital_web","url":"https://www.bswhealth.com/-/media/Project/BSW/Sites/BSWHealth/Documents/patient-tools/patient-registration-and-billing/plain-language-summary-financial-assistance-policy-tsjh.pdf","title":"[PDF] Plain Language Summary Financial Assistance Policy","fetched_on":"2026-10-10","sha256":"1133b24e1c82c695ed2c94bde1a47f54fb15a6978033d5bc24a7ab5252689666","effective_date":null}],"accuracy":null}